3D打印个性化截骨导板对全膝关节置换术髌骨高度和关节线位置的影响

王军锋; 张继晓; 王晓华; 袁亮; 孙彬; 张克; 杨滨

doi:10.16016/j.2097-0927.202112128

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3D打印个性化截骨导板对全膝关节置换术髌骨高度和关节线位置的影响

专题报道：3D打印技术在骨关节外科的临床应用 | 更新时间：2026-01-09

- 3D打印个性化截骨导板对全膝关节置换术髌骨高度和关节线位置的影响
- Effect of 3D printed patient-specific cutting guide on patellar height and joint line position in total knee arthroplasty
- 陆军军医大学学报 2022年44卷第15期页码：1557-1564
- 作者机构：
  
  1.102206 北京，北京大学国际医院骨科
  2.253800 河北衡水，故城县医院骨二科
- 作者简介：
  
  [杨滨，E-mail：yangbin@pkuih.edu.cn YANG Bin, E-mail: yangbin@pkuih.edu.cn
- 基金信息：
  
  国家自然科学基金青年科学基金(81802233);北京大学国际医院院内科研基金(YN2019ZD05);利益冲突声明本文所有作者与术中使用的关节假体厂家不存在任何利益关系
- DOI：10.16016/j.2097-0927.202112128
  中图分类号： R181.32;R319;R687.4
- 收稿：2021-12-15，
  
  修回：2022-04-24，
  
  纸质出版：2022-08-15
- 稿件说明：
移动端阅览
王军锋, 张继晓, 王晓华, 等. 3D打印个性化截骨导板对全膝关节置换术髌骨高度和关节线位置的影响[J]. 陆军军医大学学报, 2022,44(15):1557-1564.

Junfeng WANG, Jixiao ZHANG, Xiaohua WANG, et al. Effect of 3D printed patient-specific cutting guide on patellar height and joint line position in total knee arthroplasty[J]. Journal of Army Medical University, 2022, 44(15): 1557-1564.
王军锋, 张继晓, 王晓华, 等. 3D打印个性化截骨导板对全膝关节置换术髌骨高度和关节线位置的影响[J]. 陆军军医大学学报, 2022,44(15):1557-1564. DOI： 10.16016/j.2097-0927.202112128.

Junfeng WANG, Jixiao ZHANG, Xiaohua WANG, et al. Effect of 3D printed patient-specific cutting guide on patellar height and joint line position in total knee arthroplasty[J]. Journal of Army Medical University, 2022, 44(15): 1557-1564. DOI： 10.16016/j.2097-0927.202112128.

摘要

目的

探讨全膝关节置换术(total knee arthroplasty，TKA)中应用3D打印个性化截骨工具(patient-specific instrumentation，PSI)和传统工具(conventional instrumentation，CI)对患者术后髌骨高度和关节线位置的影响。

方法

回顾性分析2021年1-10月在北京大学国际医院行初次TKA手术的患者共58例。按术中选用的截骨工具类型，将入组患者分为CI-TKA组(

=22)和PSI-TKA组(

=36)，记录并比较两组患者TKA手术前后Insall-Salvati指数、改良Caton-Deschamps (mCD)指数和关节线相对高度的变化。

结果

在Insall-Salvati指数方面，CI-TKA组术前与术后差值的绝对值为0.11(0.07，0.15)，PSI-TKA组术前与术后差值的绝对值为0.06(0.03，0.12)，两组在术后Insall-Salvati指数变化上的差异有统计学意义(

0.05)。在mCD指数方面，CI-TKA组术前与术后差值的绝对值为0.16±0.09，PSI-TKA组术前与术后差值的绝对值为0.08±0.05，两组在术后mCD指数变化上的差异也具有统计学意义(

0.01)。在关节线高度方面，CI-TKA组患者术前与术后差值的绝对值为2.53(1.64，4.40)mm，PSI-TKA组术前与术后差值的绝对值为2.27(1.53，5.32)mm，两组在术后关节线位置变化上的差异无统计学意义，但两组术后关节线位置均较术前明显升高(

0.05)。

结论

使用3D打印个性化截骨工具有助于减小TKA手术对髌骨高度的影响，但在术后关节线位置的保持上与传统工具相比无明显优势。

Abstract

Objective

To compare the effect of 3D printed patient-specific instrumentation (PSI) and conventional instrumentation (CI) on the patellar height and joint line position in total knee arthroplasty (TKA).

Methods

A retrospective case-control study was carried out on 58 patients

who underwent primary TKA in our hospital from January 2021 to October 2021. According to the osteotomy tools selected in TKA

the patients were divided into CI-TKA group and PSI-TKA group. The Insall-Salvati index

modified Caton-Deschamps (mCD) index and relative height of joint line before and after TKA were recorded and compared between the 2 groups.

Results

In terms of the Insall-Salvati index

the absolute difference between preoperative and postoperative score was 0.11 (0.07

0.15) in the CI-TKA group

and 0.06 (0.03

0.12) in the PSI-TKA group

and statistical difference was seen in the postoperative index between the 2 groups

(

0.05). Similarly

the absolute difference between preoperative and postoperative mCD index was 0.16±0.09 in the CI-TKA group and 0.08±0.05 in the PSI-TKA group

and obvious difference was also seen in the postoperative difference between them (

0.01). However

the absolute difference between preoperative and postoperative joint line height was 2.53 (1.64

4.40) mm in the CI-TKA group and 2.27 (1.53

5.32) mm in the PSI-TKA group. There was no notable difference in postoperative joint line position between the 2 groups

but the position after TKA were significantly higher in both groups than that before TKA (

0.05).

Conclusion

The use of 3D printed PSI can help reduce the impact of TKA on the patella height

but there is no obvious advantage in maintaining the joint line position compared with conventional instrumentation.

关键词

Keywords

references

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